The Doctor’s Advocate | First Quarter 2020
Government Relations Report

Maternal and Child Health: When Public Health Objectives Become Legislative Priority

Remi Stone, Esq., Regional Director, Government Relations

Safe, healthy pregnancy and quality postpartum care for new mothers and their infants have been discussed in the public health policy arena for decades. Public policy in general—and public health policy specifically—address broad physical and sociopolitical environments. When public health policy interventions enter the legislative arena and become law, they have the potential to affect entire populations.

Advancing public health policy involves an interplay among physician organizations (such as medical and specialty societies), entities interested in supporting quality medical practice (such as The Doctors Company), nonprofit organizations, and elected and appointed officials. We frequently coordinate with medical societies when we advocate to ensure that legislation is effective in helping physicians treat patients and improve access to care without unduly interfering in the doctor-patient relationship or increasing physician liability.

To those in the healthcare field, it may seem obvious that improving patient care, preventing adverse outcomes, and setting the stage for a healthy life are essential public policy goals. Nevertheless, with so many interests competing for state legislators’ attention, it is difficult to engage a broad base of legislators to work on public health issues. The result is that, traditionally, important matters such as maternal and child health have not been elevated as a top-tier issue.

Elevating public health matters—including maternal and child health—to make them a priority for legislators is an ongoing challenge. An analysis published in the Journal of Public Health Management and Practice found that “public health research is often not well translated for policy audiences. Furthermore, researchers seeking to influence policy face an incomplete understanding of what influences legislators’ decisions regarding which issues will receive their limited time and focus.”

Fortunately, organizations like The Doctors Company, along with medical and specialty societies and nonprofits, work to fill this gap by employing professionals who understand how to translate complex policy ideas into meaningful conversations with legislators.

State legislators have considerable authority over which health interventions are funded, implemented, and evaluated. The Journal of Public Health Management and Practice study concluded: “Because legislators value constituents’ opinions, it is critical to inform and educate constituents about public health issues….”

Educating the public (i.e., constituents) can be expensive and take many years, but a long-term advocacy vision seems to be paying off. Efforts by many organizations have helped educate the public and elevate maternal and child health to a top-tier public policy issue for legislators in many jurisdictions across the nation and in Washington, DC. Organizations include the March of Dimes, with its goal to improve the “health of all moms and babies”; the American Congress of Obstetricians and Gynecologists, which identified maternal mortality as a top policy focus in 2018; and the American Public Health Association, which works to improve the health and well-being of all women, children, and adolescents.

Legislators appear to be listening to their constituents, who may face hospital closures in rural areas and dwindling access to obstetric care. These factors, coupled with public education, are feeding the interest of elected and appointed policymakers.

We are seeing an increased legislative interest in maternal and child health policy in our advocacy work. In 2019 alone, over 900 pieces of state and federal legislation were introduced on maternal and infant health policy—from establishing maternal mortality review committees (e.g., Arkansas House Bill 1440) to funding programs that implement care models that can result in successful maternal and infant health outcomes (e.g., Washington House Bill 2077).

A cache of on-topic bills is passing into law. For example, Illinois passed a bundle of maternal and child health policy bills into law—including HB 2433, a new law that requires hospitals to have the proper instruments for taking a pregnant woman’s blood pressure; HB 2895, which mandates yearly training in obstetric hemorrhage for all providers of obstetric medicine and includes a broader policy to implement initiatives to improve birth equity and reduce peripartum racial and ethnic disparities; and HB 3511, a mandate that birthing hospitals must provide information on maternal mental health.

The trend is expected to continue into 2020 as numerous bills introduced in state legislatures across the nation point to expanded interest in maternal mortality review committees, obstetric hemorrhaging protocols, continuing education requirements for birthing facilities personnel, birth equity initiatives, and scope of practice. The Doctors Company will continue to work on these issues to help our members deliver quality care to their patients and advance the practice of good medicine. We will continue to keep you informed about ways that upcoming legislation might affect you and your practice.

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